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General NPI Number Information
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NPI Number | 1992022784
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Entity Type | Individual
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Provider Name | MICHELE LYNN POND PT
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Gender | Female
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Dates
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Enumeration Date | 05/03/2010
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 5342 TILLY MILL RD
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City | DUNWOODY
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State | GA
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Zip | 30338-4426
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Country | US
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Telephone | 678-812-4031
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Fax |
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Provider Business Mailing Address
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Address Line | 4429 DUNMORE RD NE
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City | MARIETTA
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State | GA
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Zip | 30068-4224
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Country | US
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Telephone | 773-551-1207
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT006571
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 070.011542
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License Number State | IL
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